血管重建术治疗烟雾病术后并发症发生及其影响因素分析  

The Analysis of Postoperative Complications and the Influencing Factors During the Treatment of Revascularization of Moyamoya Disease

作　　者：李鑫[1] 秦至臻[2] 牛建星[2] 何心[2] 王建祯[2] LI Xin QIN Zhi-zhen NIU Jian-xing et al(Department of Neurosurgery , Graduate Cultivation Base, Genenral Hospital of Chinese People＇s Armed Police Force of Jinzhou Medical University ,Beijing 100039, China)

机构地区：[1]锦州医科大学北京武警总医院联合培养基地神经肿瘤外科,北京100039 [2]武警总医院神经肿瘤外科,北京100039

出　　处：《医学与哲学（B）》2016年第9期53-57,共5页Medicine & Philosophy(B)

摘　　要：探讨不同血管重建术治疗烟雾病术后并发症发生及其危险因素,为临床更为安全地预防和治疗烟雾病提供线索。通过回顾性分析66例烟雾病患者行颞浅动脉-大脑中动脉双血管搭桥术等不同血管重建术治疗的临床资料,发现不同血管重建术术后并发症发生率不完全相同,双血管搭桥术术后并发症发生率与其他手术方式无明显差异(P>0.05)。年龄、血压、术前出血及缺血症状以及饮酒史和手术方式的不同引起术后并发症发生率的差异有统计学意义(P均<0.05)。即术前出血及缺血症状以及饮酒史的患者术后并发症发生率增加;不同年龄以及不同级别高血压患者术后并发症发生率不完全相同。高血压和不同手术方式以及术前缺血、出血表现是烟雾病术后并发症发生的独立危险因素,临床上可根据患者不同情况进行积极预防及预后评估。To explore the postoperative complications of revascularizations of moyamoya disease and the influencing factors for the safer prevention and treatment of clinical disease.The clinical data of 66 patients with moyamoya disease,who were treated by doubel barrel superficial temporal artery to middle cerebral artery anastomosis or other extracranial to intracranial（EC-IC）atrerial bypass including direct bypass or direct bypas or combined direct bypass and indirect bypass surgery respectively.The observation of the 66 patients（100sides treated by revascularization）after procedures,suggested that apparent postoperative complications can be divided into neurological complications including high or low perfusion syndrome;cerebral infarction and intracranial hemorrhage and so on and non-neurological complications such as delayed wound healing and wound infection;Univariate analysis showed that high blood pressure,and preoperative bleeding,preoperative ischemic symptoms and history of drinking were closely related to postoperative complications（P〈0.05,respectively）.The high blood pressure,preoperative ischemic manifestations,preoperative bleeding and different surgical procedures were independent risk factors for postoperative complications,which can be active prevented and can provide predictable prognosis depending on the clinical condition of the patient.

关 键 词：烟雾病 术后并发症 颞浅动脉-大脑中动脉双血管搭桥术 高灌注综合征 

分 类 号：R651.12[医药卫生—外科学]